Substance abuse

“ Our findings suggest that individuals with substance use disorders may be more dangerous than individuals with schizophrenia and other psychoses, and that the psychoses comorbid with substance abuse may confer no additional risk over and above the risk associated with the substance abuse. ”

“ During National Alcohol and Drug Addiction Recovery Month, we stand with the millions of Americans in recovery from alcohol and drug addiction, and reaffirm our commitment to support those who are struggling with addiction, and their families and loved ones. Substance abuse robs Americans of their potential, shatters their families, and tears apart our communities. ”

“ Substance abuse leads to a cycle of addiction and despair that too often causes disease and death among young people. The Helping America's Youth initiative, led by First Lady Laura Bush, is promoting positive youth development and combating alcohol and drug addiction. ”

“ The more moderate the use of these substances, the more remotely is the effect removed from the cause and more difficult of detection. That the ordinary habitual, so-called moderate use of stimulants and narcotics, such as tea, coffee, tobacco, and alcohol, is, in the vast majority of cases, really an abuse, is a proposition that I think should be admitted by all who have given the subject an unbiased study. ”

“ On the other hand, the class of pains due to the action of the chronic abuse of certain therapeutic agents is unhappily an increasing one; I allude to alcohol, opium, cocaine, chloral and other drugs, originally taken for the relief of pain, which induce a pernicious habit in their unfortunate victims, of which pain is one of the main expressions. It is an undoubted fact that this class of sufferers is on the increase. Much of this tendency is due to the excessive wear and tear and the unhealthy competition of our modern civilization. ”

“ The most effective way, however, to reduce the cycle of youth drug addiction and the crime it causes is to reduce demand. This effort begins at home; and it depends upon the active participation of families, schools, and community organizations in education and outreach programs that clearly communicate to children the dangers inherent in drug and alcohol abuse. ”

“ We shall save much public money, and personal effort and time, and shall save the narcotic addict much suffering and discouragement, and shall add much to human health, competency and happiness when we realize these facts as applied to addiction-disease, and proceed upon them in a spirit of broad humanity and of rational clinical study and remedy of obvious disease symptomatology. Narcotic drug addiction-disease is a definite, and in most cases arrestable disease. ”

“ But the worst of it all is that through the carelessness of physicians, and sometimes through their criminal pretentions, habits are formed for certain drugs, such as cocaine, opium and its products, chloral and alcohol, which enslave their victims, weaken their vitality, and invite disease. I think I do not exaggerate it when I say that the drug habit, no matter how induced, is a menace to the American people. ”

“ The financial possibilities of commercial exploitation of the sufferings of addiction-disease, combined with general ignorance of the true nature of the addiction condition, are responsible for the tremendous increase of late of narcotic addiction, of non-medical or non-therapeutic origin, among the youth. ”

“ It seems to be the fact that the narcotic wards of our great charity hospitals and institutions of custody and correction still in great measure proceed with their handling of narcotic addicts on the basis of mental or moral degeneracy or deficiency or weakness of will, or morbid appetite, etc., or apply one or another of the various remedies or combinations of remedies. Their internes and nurses do not seem to graduate with a conception of addiction as a definite physical disease, with clinically significant symptomatology and constant physical reactions and phenomena. ”

“ They should be classed as innocent or [Pg 28] accidental addicts—normal and worthy sick people. They earnestly desire treatment and help, and once their addiction process is completely arrested do not tend to return to narcotic drug use. ”

“ Indeed, there could be no stronger argument in favor of the fact that addiction is an actual disease than the very phenomena presented by the occasional addict who stops taking the drug by “will power.” ”

“ The many wrecks of addicts to be seen trying through insufficient supply of narcotic drug, self-poisoned with other drugs which they have purchased, alcohol, bromides, coal tar products, cocaine, and of late hyoscine—their addiction disease unrelieved and undiminished—are sufficient argument against mere reduction of dose, below physical body need. ”

“ If the addict of a higher type displays at times attributes not typical of his preaddicted days, and seems to show a lowering of his mental and ethical tone, it is well to estimate in his case the influences of past worry, fear, suffering, strain and struggle, the attitude of society, medical and lay, towards him, and the manner in which he has been handled, before blaming it all upon the mere presence and effects of narcotic drug addiction, or of narcotic drug. ”

“ If there is no length to which a drug victim will not go rather than find himself deprived of his drug, there is no length to which he will not go in order to obtain relief from a habit the existence of which fills him with horror. ”

“ Both conditions are those of disease; the one always existing, the other springing from the prolonged use of the substance to which they become addicted. Be it distinctly understood that where, throughout this book, I have used the word “habit,” I have meant an abnormal appetite or condition, calling for the use of narcotics or stimulants, that either existed before or was produced by the use of the substance in question.
There are those who use hashisch steadily the year round, as many of our countrymen use alcohol ”

“ There is a tremendous number of excellent and worthy and even illustrious people in whom addiction is in no way associated with vice, or other morbidity of mental or environmental origin, who are merely, solely and simply sick people suffering from addiction-disease, whose problem is the control of that disease until it can be arrested by competent therapeutic procedure, for which they constantly seek. ”

“ We should show the same discernment respecting drug addiction. The addict is a sick person. He may, of course, be confined for treatment or for the protection of society. [4] Cruel and unusual punishment results not from confinement, but from convicting the addict of a crime. ”

“ The tendency of the psychologist and psychiatrist is to analyze him from the viewpoint of mental weakness, defect or degeneration, and to so classify and regard him. The average practitioner of internal medicine, and even the recognized leaders and authorities in this field of medical science will tell you that narcotic drug addiction is a condition to which they have given but little attention and have no clean-cut ideas of its physical disease problems. ”

“ In drug addictions the condition of the patient is not mental, as is generally supposed, but physical. Definite medical treatment to remove the effects of the drug itself is imperative, whether the victim be suffering from the drug habit alone or from that habit in a body otherwise physically disordered. With regard to the cure of the habit, as in the case of the conditions which permit of its being acquired, it may justly be said that the victims have been unfairly treated. ”

“ There have been many cases, after the unpoisoning was complete, in which a man or woman has been found to be as seriously ailing mentally as others have been found ailing physically. Drugs and alcohol, especially drugs, have frequently been responsible for extraordinary mental and moral twists. But it must be maintained that the use of drug or liquor is usually the result rather than the cause of such conditions. ”

“ They are the inherently irresponsible, vicious or defective. They demand care and restraint irrespective of their addiction. The mass of addicts, however, need something done for them. They are clinical problems of internal medicine, victims of a definite disease, characteristic in its symptomatology, reactions and phenomena, a disease which will before long come to be known as clinically and therapeutically controllable and arrestable. ”

“ Even the specialist in psychology, who should be able to weigh all the details of men’s mental and moral as well as physical being, seems likely to go astray when he considers a psychology that has been affected either by drink or drugs. Many physicians seem to be imbued with the idea that after a patient has once been through the process of [Pg 209] treatment for a drug or drink habit he will be entirely made over; but the fact is that the elimination of drugs or drink from a degenerate will not eliminate degeneracy. ”

“ In exact proportion as the drug of addiction is present in the body to neutralize or oppose some antidotal poison, is the patient free from withdrawal symptoms and from physical craving for the narcotic drug. ”

“ That the average medical men can remain so hopelessly, I might say criminally, negligent of the true conditions of drug addiction is a cause for wonder as well as condemnation. If the perusal of my paper induces even one conscientious physician to seek more definite information upon this tremendously vital subject, my efforts shall not have been in vain. ”

“ I believe we would have saved many people from the hell of narcotic drug addiction. I believe if it had not been for the use of the word “habit” that the medical profession would long ago have recognized and investigated this condition as a disease. A man, physician or layman, believes that he can control a habit when he would fear the development of a disease. ”

“ The constant use of narcotics produces a condition in the human body that many physicians of medical authority now recognize as a definite disease, which diseased condition absolutely requires a continued administration of narcotics to keep the body in normal function unless proper treatment and cure is provided.
“Withdrawal of the drug of addiction induces such fundamental physical disorganization and unbearable pain that addicts are driven to any extreme to obtain narcotic drugs and allay their suffering by self-administration. ”

“ Women, it should be said, though constitutionally more liable than men to feel the need of medicines, form the lesser portion of the drug-taking class. In the beginning their addiction is due almost exclusively to a physician’s prescription, except in the under-world. ”

“ The habitual use of cocaine for example, may be regarded as an indulgence of appetite and the obtaining of sensation and artificial stimulation and not as based upon the demands of a specific physical addiction-disease mechanism. The therapeutics of its discontinuance are entirely different. Habitual indulgence in cocaine tends to result in mental and moral deterioration. ”

“ But neither this combination of drugs nor any other combination known to man can prevent persons, after they are free from their addiction—be it alcohol or morphin—from going out and repoisoning themselves by taking again the drug which has poisoned them and led them on to their habitual intoxication. ”

“ The rest are impelled simply by craving—that intolerable craving which arises from deprivation of the drug.
But whether a man has acquired the habit knowingly or unknowingly, its action is always the same. No matter how conscientiously he wishes to discharge his affairs, the drug at once begins to loosen his sense of moral obligation, until in the end it brings about absolute irresponsibility. ”

“ It has yet to be demonstrated that there is any warm-blooded animal, which following sufficiently prolonged and constant administration of opiate drug, is immune to the development of the symptomatology and constant physical phenomena of addiction-disease.
Color, nationality, social or economic position, age, mental and moral attributes of whatever sort are no bar to the development of the condition. These may influence, of course, the conduct and incidental manifestations of the individual addicted, just as they do in any other condition. ”

“ The problem of the care of the worthy and innocent addict in such a way as not to unnecessarily harm him nor deprive his family and society of his competent activity is just as important as the handling of the addict of the type of individual from whom society must be protected. The large numbers of worthy and valued citizens who are individually and personally social and economic assets and who are sufferers from addiction-disease constitute a very important consideration in the narcotic problem. ”

“ It is a characteristic of the drug-taker, no matter who he is or how he acquired the habit, on the smallest excuse to advise others to take the drug whenever pain or fatigue gives the slightest occasion for it. While he grows callous to everything else, he has an abnormal sympathy with suffering. Thus it will readily be seen that there are few more dangerous members of society than the physician who is addicted to a drug. ”

“ As has been stated, it is a fact that for each addict, a definite amount, varying with his condition of health, elimination, physical and mental activity, etc., meets a definite body-need. On this amount he can be put and kept in good physical and mental condition under normal circumstances of environment, exertion, and general hygiene. Years of efficient activity and upright responsible lives, accomplished by well-known men and women, unsuspected addicts, bear witness to this fact. ”

“ Lack of understanding and appreciation of the disease of narcotic drug addiction and its treatment by a large majority of the medical profession has fostered conditions which make it impossible to determine a rational procedure for treating and curing the addicted by the State at this time. ”

“ It is indeed high time that the medical profession raised, with one accord, its voice in solemn protest against the use of all nerve-obtunding and felicity producing drugs, which are all, without exception, toxic agents, working mischief and only mischief in the human body."—Dr. ”